Amlodipine heart rate
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Effects of Amlodipine on Heart Rate: A Comprehensive Review
Introduction to Amlodipine and Heart Rate
Amlodipine, a long-acting calcium channel blocker, is widely used in the treatment of hypertension and angina pectoris. Its effects on heart rate (HR) are of significant interest, particularly in understanding its overall cardiovascular impact. This article synthesizes findings from multiple studies to provide a clear picture of how amlodipine influences heart rate.
Amlodipine and Heart Rate Variability (HRV)
Influence on HRV Parameters
Research indicates that amlodipine does not significantly alter heart rate variability (HRV) time domain parameters in hypertensive patients with stable angina pectoris and isolated left ventricular diastolic dysfunction. However, it does reduce total power, very low frequency power, and low frequency power, while maintaining high frequency power unchanged. This suggests a shift towards increased vagal activity, indicating a reduction in sympathetic autonomic nervous system activity .
Circadian Effects of Amlodipine on Heart Rate
Morning vs. Evening Dosing
A study comparing the effects of morning and evening dosing of amlodipine on circadian blood pressure and heart rate found that morning dosing had a more favorable impact on circadian blood pressure patterns. However, the study did not report significant differences in heart rate between the two dosing times, suggesting that the timing of administration may not critically affect heart rate .
Hemodynamic Effects of Amlodipine
Acute and Chronic Administration
Amlodipine has been shown to increase heart rate slightly when administered intravenously, with a noted increase from 75 to 80 beats per minute in patients with stable angina pectoris. This increase is accompanied by a decrease in systemic vascular resistance and mean arterial pressure, indicating its vasodilatory effects without significant negative inotropic effects .
Comparison with Nifedipine
When compared to nifedipine, another calcium channel blocker, amlodipine was found to decrease plasma and urinary norepinephrine levels during chronic administration, suggesting a lower sympathetic nerve activity. This reduction in sympathetic activity is beneficial for cardiovascular outcomes, as it indicates a more stable heart rate and reduced stress on the heart .
Animal Studies on Amlodipine and Heart Rate
Telemetric Monitoring in Rats
In animal studies, amlodipine was shown to increase heart rate dose-dependently, with more pronounced effects during the light span compared to the dark span. This phase-dependency highlights the complex interaction between amlodipine and circadian rhythms in cardiovascular regulation .
Cardioprotective Effects of Amlodipine
Ischemic Conditions
Amlodipine has demonstrated cardioprotective effects in ischemic conditions, such as reducing ischemia-induced ventricular conduction delay and improving myocardial function during reperfusion. These benefits are achieved without significant alterations in heart rate, suggesting that amlodipine can protect the heart during ischemic events without causing tachycardia Dunlap1989Rämö1989Lucchesi1989.
Conclusion
Amlodipine exerts a multifaceted influence on heart rate and cardiovascular function. While it can cause a slight increase in heart rate, its overall effects include reducing sympathetic activity, maintaining HRV, and providing cardioprotection during ischemic events. These properties make amlodipine a valuable agent in managing hypertension and angina, with a favorable impact on heart rate and overall cardiovascular health.
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